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Newborn Care
Diet: Breast milk or formula.
Separate information on nursing and infant feeding is available
from the office.
Take the suction bulb in the bassinet home with you. If it's not
much use for stuffy noses, it will make a good squirt gun or ear
wax cleaner later. (see "snuffles")
Acne: Pimples and blackheads often appear about
three weeks after birth and last about two months. (Keep this in
mind for scheduling photographs.) Wash face, as you do the body,
with soap and water, about every three days.
Activity: You may take the baby out at any time
after the first week. His natural resistance levels are very high
during the two months. Use common sense, however. Avoid family gatherings,
crowds and people with snivelly noses.
Your baby may sleep in his own room from the day he comes home.
Bathing: After the cord has fallen off, you may
tub-bathe your baby. Daily bathing can dry out a child's skin but
the drying is minimized if you use a thick moisturizing cream after
each bath (below). Usually, a bath every third day is plenty for
newborns. Use mild soap, such as Dove® or Basis®. Use baby
shampoo for the head and scrub up scales with a washcloth or toothbrush.
You may use either soap or shampoo on the face. After the bath,
while the skin is still moist, apply a cream such as Nivea®,
or non-perfumed Eucerin® cream, to hold in the moisture and
minimize peeling.
Babies can be bathed in a sink with a hand towel on the bottom.
Be careful to avoid hot spigots and scalding water. If possible,
adjust your domestic hot water heater down to 125° F to minimize
accidental scalding risk (and save fuel).
Portable "tubbies" are very useful. The most fun and
secure way to bathe your baby is to take him into the tub with mother
or father. Babies like very warm bathwater. Adjust the temperature
to a level that would be comfortable for you.
Bottles, sterilizing: If you are using bottles,
your baby will do well with standard "milk" nipples or
contoured "Nuk"® nipples. Playtex® nurser kits
offer no real advantages. In this area it is not necessary to sterilize
bottles or nipples. Dishwasher, or scrupulous hand-washing and rinsing
is all that is needed.
Burping: It is natural for infants, whether bottle
or breastfed, to swallow air with nursing. During the first month,
it is often hard for baby to get this air up, which may contribute
to cramping. Try burping him after every few ounces, or between
breasts, by sitting him up and rubbing his back, or holding him
over your shoulder and rubbing, or patting his back. If interrupting
the feeding makes your baby go bananas, wait until the end of feeding
to burp him.
Car seats: Massachusetts has strict infant car
seat regulations: rear-facing car seat until age 1; forward facing
car seat after age one until child weighs 40 lbs. Car seats are
very confining and your baby, like everyone else, needs pit-stops
during a long trip to get out and stretch.
Circumcision: If your baby is a boy, should he be circumcised?
We don’t think so. There are no good medical reasons
for routine newborn circumcision. Both the risks of not circumcising
a boy and the risks of circumcising are few and minor, so the decision
of whether or not to perform the operation is more dictated by custom
than by medical facts. The circumcision decision is often an emotional
issue since it is the first and possibly the only irreversible decision
a parent makes for a boy. No special care is needed for an uncircumcised
boy. As a boy grows and matures, the foreskin will loosen up by
itself with no special attention needed. Your son will learn to
wash his penis when he learns to wash the rest of his body.
Circumcision Care: All that is required is to
put a glob of Vaseline® on the tip of the penis to reduce chafing.
Minor bleeding or oozing can be stopped with light pressure with
a clean cloth.
Colic: Screaming, cramping, gassy spells. Occurs
occasionally in all newborns, frequently in some, who may show a
consistent "crying time". Colic is often made worse with
solid foods. Do not confuse colic with hunger pains. Colic is treated
best by soothing holding, walking, rides in the care, and tight
swaddling with a receiving blanket. The Ultimate Treatment, are
the expensive but durable "SnugliI®" or "Baby
Björn®" infant carrier, which may be worn on the chest
of any adult. Cinch it high to save your back.
Constipation: Babies' stool will vary tremendously
in consistency and frequency, regardless of feeding regimen. At
this age, your baby hasn't been around long enough to have a "regular"
anything. Nursing babies will normally stool anywhere from six to
seven times a day to once every three to seven days, and patterns
may change daily, all other factors being the same. The color may
be green, yellow, or brown. Consistency may be runny, gooey or semi-formed.
Some children never have formed stools.
If your bottle-fed baby has not stooled for three days and appears
uncomfortable, you can often stimulate a bowel movement by inserting
an infant-size glycerin suppository into his rectum. If the problem
persists, try diluting each four ounces of formula with an extra
ounce of water. Next, try adding 1/2 teaspoon of Dark Karo®
syrup to a bottle twice daily. Call if these remedies do not help.
Cradle Cap: Cradle cap, or seborrhea, is a common
and normal scalp rash. Cradle cap looks like yellowish, sometimes
greasy scales on a baby’s scalp, face and ears. You may scrub
this rash with a washcloth or toothbrush and baby shampoo twice
weekly. Don’t be afraid of the soft-spot.
Diapers: We recommend paper diapers for their
convenience. In terms of rashes, there is little difference between
them and cloth diapers. You might save a great deal by buying diapers
by asking the store manager if you can buy by the case.
Diaper Rashes: It is not necessary to use a diaper
cream with each changing. Should a rash begin, use a heavy application
of Desitin® ointment, which forms a second skin and protects
the skin from further urine contact. The rule with diaper rashes
is to keep the skin protected and dry and avoid over-bathing, which
can further break down the skin. "Wet wipes" are convenient
to keep in your diaper bag, but they may irritate your baby's skin
if used a great deal. At home, just wipe off your baby's bottom
quickly with a damp washcloth.
Dress: Stretch sleepers or sacks are very handy.
Wrap the child snugly in a receiving blanket and, depending on weather,
a blanket. Babies are fairly resistant to slight temperature changes.
Set the thermostat at your usual setting. During the summer, your
baby may sleep in an air-conditioned room. The baby is covered appropriately
when his hands and feet are slightly cool, and his body is warm.
Infants generally lie slightly flexed when they are comfortable.
If your baby is completely stretched out, or tightly bunched up,
he is likely too warm or cold.
Ear wax: When you bathe your baby, gently bathe
his ears with soapy water, then wipe away any ear discharge and
blot his ears dry. Getting bath water into your babies ears will
not cause ear infections. Keeping his ears clear of wax, however,
will make the job of examining his ears much easier when he does
get sick. Q-tips tend to pack wax into the ear, even when used carefully.
Eye discharge: Common for the first two weeks.
Dab it away with tap water and cotton balls. If thick and yellow
or green, call for advice.
Feeding: Should you start cereal? Generally a
bad idea. Your baby will grow more quickly on breast milk or formula
than on cereal which is just a starch filler. His digestive tract
is still immature does best on a liquid diet.
Hiccoughs are very common and often start prenatally-
that’s what a lot of those “kicks” were. They
will go away on their own. Occasionally a sip of water will help
break them up.
Safety: Use a car seat at all times! (This recommendation
is important and also is state law.) Massachusetts law requires
than an infant face to the rear in his car seat until age one.
Sleeping accommodations: Your baby’s crib
should have a firm mattress. Sheets and other mattress covers should
be taut and secure. Do not allow your baby to sleep on a water bed,
or a regular bed covered with a soft surface such as a sheepskin.
Sleeping position: Because of the possibility
that a baby’s sleep position can influence the possibility
of sudden infant death syndrome, the American Academy of Pediatrics
recommends that all infants sleep on their backs for the first few
months. In practice, we find that some babies can’t settle
down in this position. If this is the case with your baby, give
us a call so we can talk it over.
During the day when your baby is awake and you are with him, encourage
your baby to spend some time on his tummy.
Snuffles: Commonly appear about one month. Mucous
that you can see in the baby's nose can be suctioned out with an
"ear syringe" if it seems to interfere with his feeding.
Rattling mucous in the back of the throat sounds worrisome, but
is harmless, even though you can sometimes "feel it" in
the chest. Salt water drops, (1/2 teaspoon salt in 1 cup of warm
water) 1 - 2 drops to each nostril can help congested babies breathe
a little easier.
Umbilical Cord care: The cord usually falls off
between 1 - 2 weeks of age. If it looks "soupy" swab it
with rubbing alcohol twice a day. The cord is insensitive and can
be pushed back and forth to clean around the base well. If there
is some bleeding around the cord, simply apply mild pressure with
a clean cloth.
Visitors / Help: The first month is a period
of recovery, physical and social readjustment. The mother will undergo
a dramatic physical, hormonal and fluid readjustment which may produce
sharp mood swings, night sweats, hot and cold flashes. The result
of these changes, and lack of sleep, is extreme fatigue. We encourage
fathers to stay home the first week or longer, if possible.
Household help, as distinguished from visitors, can be a tremendous
relief. Friends and relatives can make the first few weeks more
enjoyable if they help with household work or caring for other children.
However, don't fall into the common trap of playing host and hostess.
Post a sign on the door to turn away well-intentioned, but uninvited
guests. If you are fortunate and can afford to hire help, we suggest
you hire a housekeeper, not a nurse. Let others take care of you,
or let housework go undone, so that you can have time for the baby.
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